Efficacy and safety of high-dose influenza vaccine in elderly adults: A systematic review and meta-analysis

Vaccine ◽  
2017 ◽  
Vol 35 (21) ◽  
pp. 2775-2780 ◽  
Author(s):  
Krista Wilkinson ◽  
Yichun Wei ◽  
Andrea Szwajcer ◽  
Rasheda Rabbani ◽  
Ryan Zarychanski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Influenza Vaccine ◽  
Meta Analysis ◽  
High Dose ◽  
Elderly Adults ◽  
Efficacy And Safety

Efficacy and safety of pharmacological cachexia interventions: systematic review and network meta-analysis

2020 ◽  
pp. bmjspcare-2020-002601
Author(s):  
Manit Saeteaw ◽  
Phitjira Sanguanboonyaphong ◽  
Jukapun Yoodee ◽  
Kaitlyn Craft ◽  
Ratree Sawangjit ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Meta Analysis ◽  
Total Body Weight ◽  
Megestrol Acetate ◽  
High Dose ◽  
Efficacy And Safety ◽  
Pharmacological Interventions ◽  
Serious Adverse Events ◽  
Significant Difference

AimsRandomised controlled trials (RCTs) demonstrated benefits of pharmacological interventions for cachexia in improving weight and appetite. However, comparative efficacy and safety are not available. We conducted a systematic review and network meta-analysis (NMA) to evaluate the relative efficacy and safety of pharmacological interventions for cachexia.MethodsPubMed, EmBase, Cochrane, and ClinicalTrials.gov were searched for RCTs until October 2019. Key outcomes were total body weight (TBW) improvement, appetite (APP) score and serious adverse events. Two reviewers independently extracted data and assessed risk of bias. NMA was performed to estimate weight gain and APP score increase at 8 weeks, presented as mean difference (MD) or standardised MD with 95% CI.Results80 RCTs (10 579 patients) with 12 treatments were included. Majority is patients with cancer (7220). Compared with placebo, corticosteroids, high-dose megestrol acetate combination (Megace_H_Com) (≥400 mg/day), medroxyprogesterone, high-dose megestrol acetate (Megace_H) (≥400 mg/day), ghrelin mimetic and androgen analogues (Androgen) were significantly associated with MD of TBW of 6.45 (95% CI 2.45 to 10.45), 4.29 (95% CI 2.23 to 6.35), 3.18 (95% CI 0.94 to 5.41), 2.66 (95% CI 1.47 to 3.85), 1.73 (95% CI 0.27 to 3.20) and 1.50 (95% CI 0.56 to 2.44) kg. For appetite improvement, Megace_H_Com, Megace_H and Androgen significantly improved standardised APP score, compared with placebo. There is no significant difference in serious adverse events from all interventions compared with placebo.ConclusionsOur findings suggest that several pharmacological interventions have potential to offer benefits in treatment of cachexia especially Megace_H and short-term use corticosteroids. Nonetheless, high-quality comparative studies to compare safety and efficacy are warranted for better management of cachexia.

scholarly journals Efficacy and Effectiveness of High-Dose Influenza Vaccine for Older Adults: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S456-S456 ◽  
Author(s):  
Jason Lee ◽  
Gary Lam ◽  
Thomas Shin ◽  
Jiyeon Kim ◽  
Anish Krishnan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Influenza Vaccine ◽  
Meta Analysis ◽  
High Dose

Immunogenicity of high-dose trivalent inactivated influenza vaccine: a systematic review and meta-analysis

2019 ◽  
Vol 18 (3) ◽  
pp. 295-308 ◽  
Author(s):  
Sandrine I. Samson ◽  
Phillip S. Leventhal ◽  
Camille Salamand ◽  
Ya Meng ◽  
Bruce T. Seet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Influenza Vaccine ◽  
Meta Analysis ◽  
High Dose

scholarly journals Efficacy and safety of low-dose versus high-dose hydrocortisone to treat hypotension in neonates: a protocol for a systematic review and meta-analysis

2021 ◽  
Vol 5 (1) ◽  
pp. e001200
Author(s):  
Katelyn Sushko ◽  
Nada Al-Rawahi ◽  
Kristi Watterberg ◽  
John Van Den Anker ◽  
Catherine Litalien ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Critically Ill ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Adrenal Function ◽  
High Dose ◽  
Cochrane Central Register ◽  
Efficacy And Safety ◽  
Registration Number

BackgroundImpaired adrenal function is a well-described entity in critically ill term and preterm neonates with systemic hypotension. The standard treatment for neonatal hypotension includes volume expanders and vasopressors. Recent evidence supports the use of glucocorticoids for the primary or rescue treatment of neonatal hypotension associated with impaired adrenal function. However, inconsistency regarding the prescribed dosing regimen to provide the best balance between efficacy and safety in this vulnerable population remains an area of concern.MethodsWe will conduct a systematic review and meta-analysis to evaluate low-dosing compared with high-dosing regimens of hydrocortisone for the treatment of hypotension in critically ill term, preterm and very low birth weight neonates. Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and Web of Science will be searched from inception to November 2021. Study screening and selection will be completed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Our primary outcomes will be (1) an improvement in end-organ perfusion, defined as an increase in blood pressure along with an increase in urine output or a reduction in serum lactate and (2) mortality prior to discharge. Our secondary outcomes will be the development of (1) major neurosensory abnormality, (2) bronchopulmonary dysplasia and (3) the occurrence of adverse events.DiscussionHydrocortisone may be beneficial in the treatment of hypotension associated with impaired adrenal function among critically ill neonates. However, its optimal dosing to balance desired efficacy with the risk of adverse events is yet to be determined. Our systematic review and meta-analysis aims to address this evidence gap, providing valuable knowledge for a large audience, including guideline developers, policy-makers and clinicians.PROSPERO registration numberThis protocol is submitted for registration to the international database of prospectively registered systematic reviews (PROSPERO, awaiting registration number).

Efficacy and safety of high-dose dual therapy forHelicobacter pylorirescue therapy: A systematic review and meta-analysis

2016 ◽  
Vol 17 (12) ◽  
pp. 811-819 ◽  
Author(s):  
Cai Ping Gao ◽  
Zhou Zhou ◽  
Jia Zhen Wang ◽  
Sheng Xi Han ◽  
Liang Ping Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Dual Therapy ◽  
High Dose ◽  
Efficacy And Safety

scholarly journals 2745. Efficacy and Effectiveness of High-Dose Influenza Vaccine for Older Adults by Circulating Strain and Antigenic Match: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S966-S967
Author(s):  
Jason K H Lee ◽  
Gary K L Lam ◽  
Thomas Shin ◽  
Sandrine I Samson ◽  
David P Greenberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Influenza Vaccine ◽  
Clinical Outcomes ◽  
Vaccine Efficacy ◽  
Hospital Admissions ◽  
Standard Dose ◽  
Influenza Infection ◽  
Meta Analysis ◽  
High Dose ◽  
Seasonal Characteristics

Abstract Background Influenza vaccine efficacy/effectiveness can vary from season to season due in part to the dominant circulating strains and antigenic matching. This study reviews the relative vaccine efficacy/effectiveness (rVE) of high-dose inactivated trivalent influenza vaccine (HD-IIV3) compared with standard-dose influenza vaccines (SD-IIV3) in adults ≥65 years against influenza-associated outcomes across all influenza seasons, during seasons where A/H3N2 or A/H1N1 strains predominantly circulated, and where there was an antigenic match or mismatch of the vaccine and circulating strains. Methods A systematic review was conducted for studies assessing the rVE of HD-IIV3 against probable/laboratory-confirmed influenza-like illness (ILI), hospital admissions, and death in adults ≥65 years. Results from individual seasons were extracted from the identified studies, and surveillance data from each season were used to determine the dominant circulating strains and antigenic match. Results were then stratified based on clinical outcomes and seasonal characteristics and meta-analyzed to estimate pooled rVEs of HD-IIV3. Results 11 studies were meta-analyzed after screening 1,018 studies, providing data on 9 consecutive influenza seasons and over 12 million individuals receiving HD-IIV3. Across all influenza seasons, HD-IIV3 demonstrated improved protection against ILI compared with SD-IIV3 (rVE = 15.9%, 95% CI: 4.1–26.3%). HD-IIV3 was also more effective at preventing hospital admissions from all-causes (rVE = 8.4%, 95% CI: 5.7–11.0%), as well as influenza (rVE = 16.1%, 95% CI: 7.4–24.1%), pneumonia (rVE = 27.3%, 95% CI: 15.3–37.6%), pneumonia/influenza (rVE = 13.4%, 95% CI: 7.3–19.2%) and cardiorespiratory events (rVE = 17.9%, 95% CI: 15.0–20.8%). Some numerical differences were observed in the pooled rVE of outcomes in matched and mismatched seasons and in seasons where A/H3N2 or A/H1N1 strains were predominantly circulating (Table 1). Conclusion Evidence over 9 influenza seasons suggest that HD-IIV3 is consistently more effective than SD-IIV3 at reducing the clinical outcomes associated with influenza infection irrespective of circulating strain and antigenic match. This study was funded by sanofi pasteur. Disclosures All authors: No reported disclosures.

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